Health Insurance Mastery Practice Exam

What action will an insurer take if it discovers an insured provided an incorrect age during the application process?

1. Adjust the coverage limits

2. Adjust the benefits payable under the policy

3. Cancel the policy immediately

4. Modify the premium amount

The correct answer is: Adjust the benefits payable under the policy

When an insurer discovers that an insured provided an incorrect age during the application process, the most appropriate action is to adjust the benefits payable under the policy. This is primarily because the age of the insured is a significant factor in determining the risk profile of an individual, which influences the coverage and benefits associated with a policy. If the insured is older than initially stated, the insurer may reduce the benefits payable to align with the risk associated with that age group, as older individuals typically face higher risks and potentially higher costs for claiming. Conversely, if the insured is younger, the insurer may consider increasing the benefits or required coverage limits based on the lower risk profile. The adjustment of benefits directly reflects the insurer's assessment of risk based on accurate age information. Maintaining the integrity of the policy's terms is crucial, and adjusting benefits ensures that they align fairly with the applicant’s true risk.